Françoise BELLOIR FURET 24320 LA TOUR BLANCHE, Perigord, France OCT Angiography in RURAL OPHTALMOLOGY docteurfbf@orange.fr

Financial Disclosures I have no financial interest to disclose.

THE USE OF OCT-ANGIOGRAPHY IN RURAL OPHTHALMOLOGY «Département» of Dordogne Population: 420,000 Ophthalmologists: 24 (so only 1 ophthalmologist for 17,500 inhabitants) (approx. 10 surgeons, others like myself are General Ophthalmologists)

The Challenge of Getting Access to Traditional Dye-Based Angiographies Closest hospitals from larger cities (Perigueux and Angouleme) do not have any Ophthalmology Department, so Fluorescein angiography (FA) and ICGA are expensive since the distance from our medical center to the diagnostic center is over 70 Km (50 miles): => patient is wasting time driving (and money when elderly patients have to use an ambulance) => plus it is very difficult to get an appointment And we all know that a fast diagnosis is both economically and socially useful I am working in a medical desert!

Case N°1: AMD 81 yo pseudophakic male treated since 2009 2014-Fluorescein Angiography Sept 2014 20 LETTERS-5P8 OCT-Angiography Feb 2015-OCTA from Optovue - 37LETTERS

CNV Detection Made Easy

Follow-Up: Perilesional Halo ++++

Case N°2: Early screening of Diabetic Retinopathy in a 65yo female patient. This was her first visit and she was unaware of her condition. OD OS

So How Has OCTA Changed My Everyday Practice? Since Feb. 2015 when I acquired AngioVue OCTA (I was previously working on Topcon’s structural OCT), I have systematically been performing OCTA in: amd other macular disorders: pseudo vitelliform, CSCr, etc. diabetes high ocular pressure>20 (air) glaucoma neurological diseases -parkinson, alzheimer, ETC. AND Before each cataract surgery

OCTA Allows Patients to Save Time & Money, and the General Ophthalmologist to Perform Faster Diagnosis & Treatment Decisions BEFORE FEBRUARY 2015: NOW WITH OCTA: Refraction: 4 minutes OCT to decide on further investigations: Mydriasis: 10 minutes Technician on Topcon OCT: 15 minutes Interpretation (myself) If FLUORESCEIN ANGIOGRAPHY necessary: Appointments for FA: about 10 days 70km drive for the patient Treatment decision (IVT) Time for diagnosis and treatment decision:10 days and 29 minutes Refraction: 4 minutes OCTA to decide on further investigations (I perform OCTA scans myself) Mydriasis: 10 minutes OCTA 3x3 or 6x6 macular scans & 4.5x4.5 optic nerve: 15 minutes Treatment decision (IVT) Time for diagnosis and treatment decision : 29 minutes only !

CONCLUSION OCT-Angiography is The Future For ALL Ophthalmologists OCTA is a new technology allowing the general ophthalmologist to reach a faster diagnostic and treatment decision for a large number of ocular pathologies. OCTA is even more useful in rural territories where access to FA and ICGA is challenging. OCTA thereby gives patients some indispensable security and access to timely administered treatment therapy, even in the most remote territories